Cost and Outcomes of Implantable Cardiac Electronic Device Infections in Victoria, Australia

Röder, Christine; Gunjaca, Vanika; Otome, Ohide; Gwini, Stella May; Athan, Eugene

doi:10.1016/j.hlc.2019.10.010

Cited by 7 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When antimicrobial therapy fails, or other complications arise due to IE such as valve leakage or abscess, these patients often require surgery. At least 50% of IE patients are estimated to undergo surgery during hospitalization, and when stratified for tissue or device this is 54% for NVE, 46% for PVE, and 65–95% for CDRIE ( Ortiz-Bautista et al, 2017 ; Habib et al, 2019 ; Roder et al, 2020 ). Surgery can be required however also cannot be a treatment option due to patient refusal, high surgical risk, neurological complications, or death before surgery ( Ortiz-Bautista et al, 2017 ; Habib et al, 2019 ).…”

Section: Treatment and Outcomesmentioning

confidence: 99%

“…Most cases of CDRIE managed by surgery underwent surgical device removal (95%) ( Ortiz-Bautista et al, 2017 ; Habib et al, 2019 ; Roder et al, 2020 ; Jędrzejczyk-Patej et al, 2021 ). Adverse effects of device removal include acute renal failure (21%), shock (15%), embolization (13%), and persistent fever (12%) ( Habib et al, 2019 ).…”

Section: Treatment and Outcomesmentioning

confidence: 99%

“…For implicated cardiac device drivelines, initial surgical management can include drainage and dead tissue debridement. When stratified for pacemakers and implantable cardioverter-defibrillators, 47–53% patients underwent percutaneous lead extraction, 41–53% surgical lead extraction, and 5% percutaneous catheter extraction ( Ortiz-Bautista et al, 2017 ; Habib et al, 2019 ; Roder et al, 2020 ; Jędrzejczyk-Patej et al, 2021 ). Device reimplantation occurs once a negative blood-culture is obtained, which in 77% of patients was after a median time of 13 days ( Ortiz-Bautista et al, 2017 ).…”

Section: Treatment and Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Native valve, prosthetic valve, and cardiac device-related infective endocarditis: A review and update on current innovative diagnostic and therapeutic strategies

Kouijzer

Noordermeer²,

Leeuwen³

et al. 2022

Front. Cell Dev. Biol.

View full text Add to dashboard Cite

Infective endocarditis (IE) is a life-threatening microbial infection of native and prosthetic heart valves, endocardial surface, and/or indwelling cardiac device. Prevalence of IE is increasing and mortality has not significantly improved despite technological advances. This review provides an updated overview using recent literature on the clinical presentation, diagnosis, imaging, causative pathogens, treatment, and outcomes in native valve, prosthetic valve, and cardiac device-related IE. In addition, the experimental approaches used in IE research to improve the understanding of disease mechanisms and the current diagnostic pipelines are discussed, as well as potential innovative diagnostic and therapeutic strategies. This will ultimately help towards deriving better diagnostic tools and treatments to improve IE patient outcomes.

show abstract

Section: Treatment and Outcomesmentioning

confidence: 99%

Section: Treatment and Outcomesmentioning

confidence: 99%

Section: Treatment and Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Native valve, prosthetic valve, and cardiac device-related infective endocarditis: A review and update on current innovative diagnostic and therapeutic strategies

Kouijzer

Noordermeer²,

Leeuwen³

et al. 2022

Front. Cell Dev. Biol.

View full text Add to dashboard Cite

show abstract

“…Infation was calculated using the consumer price index (CPI) [17][18][19] for each year and 2014 to determine costs as of 2014. Te CPI for the relevant years was obtained from the Australian Taxation ofce [17,19,20]. Te cost is expressed as AUD.…”

Section: Statistics Te Data Was Recorded In Microsoft Excel and Descr...mentioning

confidence: 99%

The Economic Burden of Infective Endocarditis due to Injection Drug Use in Australia: A Single Centre Study—University Hospital Geelong, Barwon Health, Victoria

Otome

Wright

Gunjaca

et al. 2022

Interdisciplinary Perspectives on Infectious Diseases

Self Cite

View full text Add to dashboard Cite

Background. Injection drug use (IDU) is a well-recognized risk factor for infective endocarditis (IE). Associated complications from IDU result in significant morbidity and mortality with substantial cost implications. The aim of this study was to determine the cost burden associated with the management of IE due to IDU (IE-IDU). Methods. We used data collected prospectively on patients with a diagnosis of IE-IDU as part of the international collaboration on endocarditis (ICE). The cost of medical treatment was estimated based on diagnosis-related groups (DRG) and weighted inlier equivalent separation (WIES). Results. There were 23 episodes from 21 patients in 12 years (2002 to 2014). The costing was done for 22 episodes due to data missing on 1 patient. The median age was 39 years. The gender distribution was equal. Heroin (71%) and methamphetamine (33%) were the most frequently used. 74% (17/23) required intensive care unit (ICU) admission. The median ICU length of stay (LOS) was 4 days (IQR (Interquartile range); 2 to 40 days) whilst median total hospital LOS was 40 days (IQR; 1 to 119 days). Twelve patients (52%) underwent valve replacement surgery. Mortality was 13% (3/23). The total medical cost for the 22 episodes is estimated at $1,628,359 Australian dollars (AUD). The median cost per episode was a median cost of $ 61363 AUD (IQR: $2806 to $266,357 AUD). We did not account for lost productivity and collateral costs attributed to concurrent morbidity. Conclusion. Within the limitations of this small retrospective study, we report that the management of infective endocarditis caused by injection drug use can be associated with significant financial cost.

show abstract

“… 7 , 8 , 9 Despite these considerable needs, no data are currently available about the excess in length of hospital stay and hospitalization costs attributable to these complications. Although cost‐analysis of procedural complications has been performed for other procedures such as implantable cardiac defibrillators implantation, 10 , 11 , 12 a similar analysis has not been conducted for AF ablation.…”

mentioning

confidence: 99%

Excess Bed Days and Hospitalization Costs Associated With 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation

Ngo,

Denman,

Hay

et al. 2023

JAHA

View full text Add to dashboard Cite

Background The incidence and type of complications following catheter ablation of atrial fibrillation have been extensively examined, but the impact associated with these complications on the length of stay and hospitalization costs is unknown. Methods and Results This cohort study included 20 117 adult patients (mean age 62.6±11.4 years, 30.3% women, median length of stay 1 day [interquartile range 1–2 days]) undergoing atrial fibrillation ablation in financial years 2011 to 2017 in Australia with available cost data from the National Hospital Cost Data Collection, which determines government reimbursement of health services provided. The primary outcome was the costs associated with complications occurring up to 30 days postdischarge adjusted for inflation to 2021 Australian dollars. We used generalized linear models to estimate the increase in length of stay and cost associated with complications, adjusting for patient characteristics. Within 30 days of hospital discharge, 1151 (5.72%) patients experienced a complication with bleeding (3.35%) and pericardial effusion (0.75%) being the most common. On average, the occurrence of a complication was associated with an adjusted 3.3 (95% CI, 3.1–3.6) excess bed days of hospital care (totaling 3851 days), and a $7812 (95% CI, $6754–$8870) increase in hospitalization cost (totaling $9.0 million). Most of the total excess cost was attributable to bleeding ($3.8 million, 41.9% of total excess cost) and pericardial effusion ($1.6 million, 18.2%). Conclusions Complications following atrial fibrillation ablation were associated with significant increase in length of stay and hospitalization costs, most of which were attributable to bleeding and pericardial effusion. Strategies to improve procedural safety and reduce health care costs should focus on these complications.

show abstract

Cost and Outcomes of Implantable Cardiac Electronic Device Infections in Victoria, Australia

Cited by 7 publications

References 16 publications

Native valve, prosthetic valve, and cardiac device-related infective endocarditis: A review and update on current innovative diagnostic and therapeutic strategies

Native valve, prosthetic valve, and cardiac device-related infective endocarditis: A review and update on current innovative diagnostic and therapeutic strategies

The Economic Burden of Infective Endocarditis due to Injection Drug Use in Australia: A Single Centre Study—University Hospital Geelong, Barwon Health, Victoria

Excess Bed Days and Hospitalization Costs Associated With 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation

Contact Info

Product

Resources

About